To the Editor.—In medical science (iatrology) "it is axiomatic that each advance in treatment brings a fresh crop of problems in its wake."1 In ophthalmology, this phenomenon can be witnessed by the increased prevalence of diabetic blindness that has occurred since the start of insulin usage. It might be said that insulin is a mixed blessing, although few would question the continued use thereof. Thus, insulin therapy is considered proper, even though it leads to iatrogenic (induced by a physician) disease. The risk/benefit ratio has been studied and found to favor its usage.There is another category of iatrogenic diseases, however, caused by the physician's incompetence, error, neglect, and, as recently stressed,2 ignorance, greed, or even malice. Therefore, in the evaluation of iatrogenic diseases, such as the complications of a new surgical procedure, it becomes critical to determine what causes these complications, how avoidable they are, and